Heart disease more likely for adults with dysfunctional childhoods

Children who experience trauma, abuse, neglect and family dysfunction are at increased risk of having heart disease in their 50s and 60s, according to a new Northwestern Medicine study.

Results from the study showed people exposed to the highest levels of childhood family environment adversity were more than 50 percent more likely to have a cardiovascular disease event such as a heart attack or stroke over a 30-year follow-up.

The longitudinal study of more than 3,600 participants is among the first to describe the trajectory of cardiovascular disease and death based on family environment ratings from young adulthood into older middle age.

Children who experience this type of adversity are predisposed to higher rates of lifelong stress, smoking, anxiety, depression and sedentary lifestyle that persist into adulthood. These can lead to increased body mass index (BMI), diabetes, increased blood pressure, vascular dysfunction and inflammation.

“This population of adults is much more likely to partake in risky behaviors – for example, using food as a coping mechanism, which can lead to problems with weight and obesity,” said first author Jacob Pierce, a fourth-year medical student at Northwestern University Feinberg School of Medicine. “They also have higher rates of smoking, which has a direct link to cardiovascular disease.”

Adults who were exposed to these risk factors as children may benefit from counseling on the link between coping with stress and controlling smoking and obesity, but more research is needed, Pierce said.

“Early childhood experiences have a lasting effect on adult mental and physical well-being, and a large number of American kids continue to suffer abuse and dysfunction that will leave a toll of health and social functioning issues throughout their lives,” said senior author Joseph Feinglass, research professor of medicine and of preventive medicine at Feinberg. “Social and economic support for young children in the United States, which is low by the standards of other developed countries, has the biggest ‘bang for the buck’ of any social program.”

The study used the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a prospective cohort that has followed participants from recruitment in 1985-1986 through 2018, to determine how childhood psychosocial environment relates to cardiovascular disease incidence and mortality in middle age.

To get a broad idea of what a study participant’s family environment was like during their childhood, participants answered survey questions that asked questions such as, “How often did a parent or other adult in the household make you feel that you were loved, supported, and cared for?” or “How often did a parent or other adult in the household swear at you, insult you, put you down or act in a way that made you feel threatened?”

The most predictive of cardiovascular disease later in life was “Did your family know what you were up to as a kid?” Pierce said.

While the study didn’t specifically address attentiveness of parents, the findings indicate parents’ involvement in their children’s lives could impact their health later in life.

Kiarri N. Kershaw, associate professor of epidemiology at Feinberg, is a co-author on the paper.

Funding for the study was provided by CARDIA contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI), the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005), all of the National Institutes of Health.